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Guide
to Effective Programs
for Children and Youth |
Home Visiting to Vulnerable Families by Nurses
OVERVIEW
This program addressed high-needs families with newborn children who were at risk for poor health and development. The program provided home visits by child health care nurses. Results showed the visits having no significant impact on child health after six weeks, but did indicate increases in parent and family functioning and parental satisfaction with community health services.
The program provided home visits by child health care nurses who attend to families’ health and social needs. The nurse home visits occurred weekly for the first six weeks and ever other week after that until three months, and monthly until 6 months postpartum. The goals of the nurse home visits were to first establish a relationship of trust with the infant’s family. The program worked to enhance the parenting self-esteem and confidence of participants as well as provide guidance for parents on normal child development. The program also promoted preventive child health care and helped parents access appropriate community services.
Armstrong, K. L., Fraser, J. A., Dadd, M. R., & Morris, J. (1999). A randomized, controlled trial of nurse home visiting to vulnerable families with newborns. Journal of Pediatrics and Child Health, 35, 237-244.
Approach: Data were collected from participants in their homes at time of enrollment and when the infant was six weeks of age. At both points, the researchers collected data on parenting stress and maternal depression. At six weeks, the researchers measured preventive health behavior, service satisfaction, and home environment outcomes as well as child health outcomes.
Child health outcomes were measured using a 30-item self-report questionnaire developed for the study, which was completed by mothers after six weeks. Parent and family functioning were measured using the Edinburgh Post Natal Depression Scale and the Parent Domain subscale of the Parenting Stress Index. To measure Home environment, the researchers used the Home Observation for Measurement of the Environment Inventory. Finally, the researchers measured satisfaction with community child health services using the Parent Satisfaction Questionnaire-III.
At enrollment, there were some differences between the intervention and control groups. In the intervention group, there were more first-time mothers, fewer mothers reported a past history of postnatal depression, fewer mothers had partners with histories of psychiatric illness, and fewer mothers reported physical forms of domestic violence.
Results: Results of the study indicated that both the intervention and control group experienced improvements in child health related outcomes such as infant sleep position; but there were no significant differences between the two groups. Also, no impacts on breastfeeding were found. The researchers note that halfway through the study, a mass media campaign designed to affect child health outcomes was launched. The researchers acknowledge that this may have accounted for changes in the groups.
In addition, the researchers found there were significant impacts on parent and family functioning. Program participants experienced a significant reduction in scores on the Edinburgh Post Natal Depression Scale. In addition, program participants reported being more satisfied with their parental role. There were also significant differences found on the home environment with program participants experiencing a positive impact. Finally, program participants reported significantly more satisfaction with the program than control group members did with standard community health services.
Program categorized in this guide according to the following:
Evaluated participant ages: Birth-6 weeks / Program age ranges in the Guide: 0-5
Program components: home visiting
Measured outcomes: life skills; physical health
Program information last updated 11/13/06
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© Child Trends 2003 |